The effects of electro-acupuncture (EA) are comparable with those of the drug gabapentin (GP) for improving sleep disturbances among breast cancer survivors. American investigators analysed data from a randomised trial involving 58 breast cancer survivors who were experiencing bothersome hot flushes at least twice per day. Participants were randomly assigned to receive eight weeks of EA (twice a week for two weeks and then weekly for six weeks) or daily GP. By the end of treatment, the mean improvement in total sleep scoresw were significantly greater in the EA group compared with the GP group (-2.6 versus -0.8). EA also improved sleep compared with the GP group: By week eight, the EA group showed improved sleep duration, less sleep disturbance, shorter sleep latency, decreased daytime dysfunction, improved sleep efficiency and better sleep quality compared with baseline, whereas the GP group improved only in duration and sleep quality.
Comparative effectiveness of electro-acupuncture versus gabapentin for sleep disturbances in breast cancer survivors with hot flashes: a randomized trial. Menopause. 2016 Nov 21. [Epub ahead of print].

Acupuncture seems to be an effective therapy for hot flushes (HFs) experienced by women with breast cancer (BC), according to a Chinese systematic review. The authors examined data from 12 RCTs (672 women) comparing manual acupuncture and electro-acupuncture with a variety of controls. Meta-analysis indicated a reduction in the number of HFs and an improvement in overall menopause symptom scores after acupuncture treatment and during follow-up compared with controls. However, the generally poor quality of the evidence means that there is a need for more studies.

Acupuncture in association with enhanced self-care is an effective integrative intervention for managing hot flushes and improving quality of life in women with breast cancer, according to Italian researchers. A pragmatic, randomised controlled trial compared acupuncture plus enhanced self-care versus enhanced self-care alone in 190 women with breast cancer. Both groups received a booklet with information about climacteric syndrome and its management, to be followed for at least 12 weeks. In addition, the acupuncture group received 10 l acupuncture treatment sessions. Evaluation of tongue and pulse was performed at each session and acupuncture was performed at three common acupoints (Sanyinjiao SP-6, Quchi L.I.-11 and Guanyuan REN-4), plus others chosen according to the specific TCM pattern diagnosed. Acupuncture plus enhanced self-care was associated with a significantly lower hot flush score than enhanced self-care alone at the end of treatment, and at three- and six-month post-treatment follow-up. Acupuncture was also associated with fewer climacteric symptoms and higher quality of life in vasomotor, physical and psychosocial domains.
Acupuncture As an Integrative Approach for the Treatment of Hot Flashes in Women With Breast Cancer: A Prospective Multicenter Randomized Controlled Trial (AcCliMaT). J Clin Oncol. 2016 Mar 28. pii: JCO632893. [Epub ahead of print].

A preliminary study from Taiwan suggests that both static and moving forms of qigong practice are beneficial for breast cancer patients undergoing chemotherapy. A quasi-experimental design was applied to the study of 95 females who were receiving chemotherapy for breast cancer. Participants were assigned to three groups; the control group undertook a post-surgical exercise programme; the non-sporting qigong (NSQG) group performed a meditative breathing exercise while either sitting or standing; and the sporting qigong (SQG) group performed tai chi-like moving qigong exercises. Patients performed their exercises for at least 30 minutes, three times per week for 12 weeks. At one and three months after beginning the program, patients in the SQG group showed lower frailty scores than those in the control group. At three months from baseline, patients in the NSQG group also reported lower frailty scores and higher mental QOL than those in the control group.
Effects of non-sporting and sporting qigong on frailty and quality of life among breast cancer patients receiving chemotherapy. Eur J Oncol Nurs. 2015 Nov 21. pii: S1462-3889(15)30043-0..

An American study suggests that electro-acupuncture (EA) may be more effective for managing hot flushes among breast cancer survivors than the drug gabapentin (GP), with fewer adverse effects. The randomised controlled trial involved 120 survivors of breast cancer who experienced hot flushes at least twice per day. Participants were randomly assigned to receive eight weeks of EA or GP once per day and these active treatments were compared with sham acupuncture (SA) and placebo pills (PP). EA aimed at treating hot flushes was carried out for 30 minutes, with additional points were chosen on the basis of subjects’ other presenting symptoms. SA followed the same protocol with non-penetrating sham needles. At week 8, comparing all treatment groups, the mean reduction in hot flush scores was greatest in the EA group. SA elicited a significantly greater placebo response compared with PP. The pill groups also reported significantly more treatment-related adverse events than the acupuncture groups. At week 24 follow-up, hot flush score reduction was still greatest in the EA group. (-8.5, -6.1, -4.6 and -2.8 respectively).

Researchers from the USA suggest that electro-acupuncture (EA) may be more effective, and result in fewer adverse effects, than the drug gabapentin (GP) for managing hot flushes in breast cancer survivors. They conducted a randomised controlled trial involving 120 survivors of breast cancer who were experiencing hot flushes at least twice per day. Participants were randomly assigned to one of four groups. The EA group received eight weeks of EA treatment, the drug therapy group received GP once per day, the placebo acupuncture group received sham acupuncture (SA) and the final group received placebo pills (PP). By week eight, comparing all groups, the mean reduction in hot flush scores was found to be greatest in the EA group (-7.4), followed by SA (-5.9), GP (-5.2 ) and PP (-3.4). In addition, the two pill groups reported significantly more treatment-related adverse events than the two acupuncture groups. At 24-week follow-up, hot flush symptom score reduction was still greatest in the EA group.
Electroacupuncture Versus Gabapentin for Hot Flashes Among Breast Cancer Survivors: A Randomized Placebo-Controlled Trial. J Clin Oncol. 2015 Aug 24. pii: JCO.2015.60.9412.

A study by UK researchers has found acupuncture to be effective at managing cancer-related fatigue (CRF). Three hundred and two breast cancer patients participated in a pragmatic, randomized controlled trial that compared acupuncture with enhanced usual care. Acupuncture treatment was given once a week for six weeks using three pairs points (Zusanli ST-36, Sanyinjiao SP-6 and Hegu L.I.-4). The enhanced usual care group received usual care a booklet with information about fatigue management. Those who received acupuncture showed significant improvements in overall fatigue, physical and mental fatigue, activity, motivation, psychological distress and quality of life. The authors speculate that the benefits of acupuncture in treating fatigue may in part mediated by its effect on pro‑inflammatory cytokines. (Acupuncture for Cancer-Related Fatigue in Patients With Breast Cancer: A Pragmatic Randomized Controlled Trial. J Clin Oncol. 2012 Oct 29. [Epub ahead of print]).

A Swedish pilot study has tested a modified single subject experimental design for evaluating the use of acupuncture for emesis during radiotherapy. Ten cancer patients were randomised to verum penetrating acupuncture or non-penetrating sham needles for 30 minutes, two to three times per week during radiotherapy. They answered test-retested emesis questions covering nausea, vomiting, use of antiemetics, wellbeing and activities of daily living. Overall, the patients completed 98% of the 345 emesis-questionnaire days. Ten patients experienced antiemetic effects, seven relaxation, five pain-reduction and five experienced sleep improvement. Nausea was experienced by one out of five verum acupuncture-treated patients and four out of five sham acupuncture treated patients. (Pilot testing of methods for evaluation of acupuncture for emesis during radiotherapy: a randomised single subject experimental design. Acupunct Med. 2011 Apr 3). A study published by some of the same Swedish authors has found no difference between verum and sham acupuncture for treating nausea in cancer patients undergoing radiotherapy. Two hundred and seventy-seven cancer patients were randomised to receive verum (penetrating) acupuncture at Neiguan P-6 or sham acupuncture (performed with a telescopic non-penetrating needle at a sham point) two to three times per week during radiotherapy. The acupuncture cohort was compared to a reference cohort receiving standard care. Nausea and vomiting during the preceding week was reported by 8% of the verum acupuncture group, 7% of the sham acupuncture group and 15% of the standard care group respectively. Nausea intensity was lower in the acupuncture cohort compared to the standard care cohort and 95% of the acupuncture cohort expected antiemetic effects from their treatment. Patients who expected nausea had increased risk for nausea compared to those who expected low risk for nausea. The authors conclude that patients treated with verum or sham acupuncture experienced less nausea and vomiting compared to patients receiving standard care, possibly through a general care effect or due to a high level of patient expectancy. (Getting the grip on nonspecific treatment effects: emesis in patients randomized to acupuncture or sham compared to patients receiving standard care. PLoS One. 2011 Mar 23;6(3):e14766).

Having weekly acupuncture treatment following chemoradiotherapy (CRT) head and neck cancer (HNC) may reduce patients’ symptom severity and decrease the amount of time they need to undergo tubal feeding. In a retrospective case series, ten American patients with HNC were treated with weekly manual and electroacupuncture for radiation-induced dysphagia (difficulty swallowing) and xerostomia (dry mouth). Nine out of ten patients reported subjective improvement in swallowing, xerostomia, pain and fatigue levels. Six out of seven patients had their feeding tubes removed after acupuncture, at a median duration of 114 days post CRT, which represents a relatively short time under such circumstances. (Acupuncture for dysphagia after chemoradiation therapy in head and neck cancer: a case series report. Integr Cancer Ther. 2010 Sep;9(3):284-90).

Meanwhile, a Norwegian study has examined the quality of life of breast cancer patients on anti-oestrogen medication, two years after receiving acupuncture treatment for hot flushes. Forty-one women from an acupuncture treatment group and 41 women from a sham acupuncture control group had received a course of 15 acupuncture treatments over a period of 10 weeks two years previously. Qualitative data showed that women previously treated with sham acupuncture complained that hot flushes were still a problem, whilst those previously treated with traditional Chinese acupuncture found them less problematic and generally had a more positive outlook on life. (Quality of life of breast cancer patients medicated with anti-estrogens, 2 years after acupuncture treatment: a qualitative study. Int J Womens Health. 2010 Sep 28;2:319-25).